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Poma S, Modica DM, Cascio F, Mattina G, Lentini VL, Basile GC, Pitruzzella A, Galfano GM. Endoscopic Endonasal Resection of a Schwannoma of the Anterior Cranial Fossa. EAR, NOSE & THROAT JOURNAL 2020; 101:NP41-NP44. [PMID: 32790588 DOI: 10.1177/0145561320943348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Salvatore Poma
- Department of Otorhinolaryngology, 9341Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Domenico Michele Modica
- Department of Otorhinolaryngology, 9341Villa Sofia-Cervello Hospital, Palermo, Italy.,Otorhinolaryngology Section, Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy
| | - Filippo Cascio
- Department of Otorhinolaryngology, 18597Papardo Hospital, Messina, Italy
| | - Gianfranco Mattina
- Department of Otorhinolaryngology, 9341Villa Sofia-Cervello Hospital, Palermo, Italy.,Otorhinolaryngology Section, Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy
| | | | - Giorgio Carmelo Basile
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, 18980University of Messina, Italy
| | - Alessandro Pitruzzella
- Department of Biomedicine Neuroscience and Advanced Diagnostics, University of Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy
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Olfaction in Juvenile Nasopharyngeal Angiofibroma: The first study. Am J Otolaryngol 2020; 41:102298. [PMID: 32451287 DOI: 10.1016/j.amjoto.2019.102298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/09/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND To study the pattern of olfactory dysfunction/recovery in juvenile nasopharyngeal angiofibroma (JNA). METHODS Olfactory assessment was undertaken in 30 patients (category1) both pre- & post-operatively and in another 18 (category 2) only postoperative. All patients underwent transpalatal excision and variables of interest included age, radiological stage/parameters & tumor size. RESULTS Objective olfactory dysfunction was seen in 60% while involvement of olfactory strip was suggested in 50%. Despite some marginal trends only noted between size/age with change of olfaction, Pearson's correlation test did not reveal any significance amongst multiple variables. However a better recovery of olfaction following surgery was evident in Category-2 where Chi-Square test (p < 0.05) significantly revealed this to be a function of postoperative duration. This regenerative course in JNA suggests an optimum period of 4 years for full recovery after surgery. CONCLUSION In this first study of olfaction in JNA many new trends have been appreciated. In general, deteriorations of olfaction were seen due to 'vascular-concussion' effect in early postoperative phase where post-surgical clearance of airway showed minimal effect in terms of improvement. The hypervascularity of olfactory epithelium with possible hormonal effects may be responsible for the unique pattern of olfactory function and recovery in JNA.
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Oertel J, Senger S, Linsler S. The extended endoscopic approach to perisellar and skull base lesions: is one nostril enough? Neurosurg Rev 2019; 43:1519-1529. [PMID: 31529228 DOI: 10.1007/s10143-019-01171-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 12/17/2022]
Abstract
The extended endonasal endoscopic approach to the skull base is still under investigation. The main advantage of using this technique is to approach lesions in a minimally invasive manner resulting without brain retraction. Here, the authors present the results of extended endonasal endoscopic surgery via one nostril. All skull base procedures performed via an endonasal approach at the author's Department between January 2011 and May 2017 were analysed prospectively. Special attention was paid to complications, radicality, advantages and disadvantages of the endoscopic technique. Additionally, the application of various telescopes and the technique of dural closure were analysed. Sixty-two patients were operated on various pathologies of the skull base via an extended endonasal approach. Seven pathologies were resected via binostril technique. All other pathologies could be exposed by the mononostril technique. In 2 of 62 cases, the authors had to switch to binostril technique. MRI revealed radical gross total resection in 93% of all cases when intended. Overall complication rate was 16% (9/55) in the mononostril and 57% (4/7) in the binostril cohort. Seven patients in the mononostril cohort (13%) versus three patients in the binostril cohort (43%) complained of postoperative nasal congestion. This clinical report shows that many extended skull base lesions can be treated by a mononostril endonasal approach. In selected cases, this technique might represent an alternative to the binostril approach. Nevertheless, the binostril technique offers a better range of manipulation and exposure and should be preferred in difficult and very extended cases.
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Affiliation(s)
- Joachim Oertel
- Department of Neurosurgery, Saarland University, Homburg, Germany
| | - Sebastian Senger
- Department of Neurosurgery, Saarland University, Homburg, Germany
| | - Stefan Linsler
- Department of Neurosurgery, Saarland University, Homburg, Germany. .,Klinik für Neurochirurgie, Universität des Saarlandes, 66421, Homburg, Saar, Germany.
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Hadjigeorgiou GF, Strouthou EM, Koulousakis D, Patsouris V, Neff F, Lumenta CB, Schul DB. Olfactory schwannomas – an enigmatic clinical entity. Br J Neurosurg 2019. [DOI: 10.1080/02688697.2019.1661968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Georgios F. Hadjigeorgiou
- Department of Neurosugery, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University Munich, Munich, Germany
- School of Medicine, European University of Cyprus, Nicosia, Cyprus
| | | | - Dimitri Koulousakis
- Department of Neurosugery, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University Munich, Munich, Germany
| | | | - Frauke Neff
- Department of Pathology, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University Munich, Munich, Germany
| | - Christianto B. Lumenta
- Department of Neurosugery, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University Munich, Munich, Germany
| | - David B. Schul
- Department of Neurosugery, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University Munich, Munich, Germany
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Taha MM, AlBakry A, ElSheikh M, AbdelBary TH. Olfactory Nerve Schwannoma: A Case Report and Review of the Literature. Surg J (N Y) 2018; 4:e164-e166. [PMID: 30206542 PMCID: PMC6131093 DOI: 10.1055/s-0038-1669991] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 08/09/2018] [Indexed: 12/01/2022] Open
Abstract
Schwannomas are benign tumors, which arise from the Schwann cells of the central or peripheral nerves. They form 8% of all intracranial tumors and most of the cases arise from vestibular division of the 8
th
cranial nerve. Rare cases are shown to arise from the olfactory or optic nerve, being devoid of myelin sheath. Up to date and according to our best of knowledge, 66 cases have been reported till now. Here we present a review of the literature and a case report of a 56-year-old male with an accidently discovered anterior cranial fossa schwannoma, following a road traffic accident. Tumor was completely excised, using a right frontal approach. Histopathology revealed Antoni-A cellular pattern. Although rare, but olfactory nerve schwannomas should be included in the differential diagnosis in anterior cranial fossa space occupying lesions, and the approach should be designed taking into consideration, this rare entity.
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Affiliation(s)
- Mahmoud M Taha
- Department of Neurosurgery, Zagazig University, Zagazig, Egypt
| | - Amr AlBakry
- Department of Neurosurgery, Zagazig University, Zagazig, Egypt
| | - Magdy ElSheikh
- Department of Neurosurgery, Zagazig University, Zagazig, Egypt
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Yoneoka Y, Akiyama K, Seki Y, Hasegawa G, Kakita A. Frontoethmoidal Schwannoma with Exertional Cerebrospinal Fluid Rhinorrhea: Case Report and Review of Literature. World Neurosurg 2018; 111:381-385. [PMID: 29330076 DOI: 10.1016/j.wneu.2018.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 12/30/2017] [Accepted: 01/03/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Frontoethmoidal schwannomas are rare. No case manifesting exertional cerebrospinal fluid (CSF) rhinorrhea has ever been reported to the best of our knowledge. CASE DESCRIPTION In this report, we describe an extremely rare case of frontoethmoidal schwannoma extending through the olfactory groove with exertional CSF rhinorrhea as the initial symptom. A 50-year-old woman was presented to our clinic for frequent nasal discharge on exertion. A postcontrast computed tomographic scan demonstrated heterogeneously enhanced tumor from the anterior cranial fossa to the anterior ethmoid sinus. A gadolinium-enhanced T1-weighted magnetic resonance image revealed a well-defined heterogeneously enhanced tumor situated in the midline anterior cranial fossa and anterior ethmoid sinus. After the resection, the defect of the right anterior skull base was reconstructed with a fascia graft and adipose tissue taken from the abdomen, as well as a pedicle periosteum flap. A histologic examination revealed the tumor as schwannoma. Her rhinorrhea completely resolved. She regained her sense of smell and taste 1 month after the operation. CONCLUSION According to previous reports, olfactory groove, and paraolfactory groove/periolfactory groove schwannomas can be divided into 4 types: subfrontal, nasoethmoidal, frontoethmoidal, and ethmofrontal. Among them, a frontoethmoidal schwannoma can manifest exertional CSF rhinorrhea as an initial symptom.
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Affiliation(s)
- Yuichiro Yoneoka
- Department of Neurosurgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan; Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan.
| | - Katsuhiko Akiyama
- Department of Neurosurgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yasuhiro Seki
- Department of Neurosurgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Go Hasegawa
- Department of Pathology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan
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Esquivel-Miranda M, De la O Ríos E, Vargas-Valenciano E, Moreno-Medina E. Schwannoma de base anterior de cráneo. Neurocirugia (Astur) 2017; 28:298-305. [DOI: 10.1016/j.neucir.2017.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 10/19/2022]
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Peris Celda M, Kenning T, Pinheiro-Neto CD. Endoscopic Superior Ethmoidal Approach for Anterior Cranial Base Resection: Tailoring the Approach for Maximum Exposure with Preservation of Nasal Structures. World Neurosurg 2017; 104:311-317. [PMID: 28465271 DOI: 10.1016/j.wneu.2017.04.148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 04/21/2017] [Accepted: 04/22/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Traditional endoscopic anterior cranial base resection involves the total removal of the ethmoidal cells, including the middle and superior turbinates. This is associated with increased volume of the nasal cavity postoperatively, with increased crusting and permanent change of the nasal airflow. Here we provide a step-by-step description of the technique and evaluate the feasibility of the superior ethmoidal approach for anterior cranial base resection with maximum exposure of the anterior cranial base while keeping the middle turbinates, uncinate processes, and ostiomeatal complexes intact. METHODS Three fresh cadaveric heads were used for dissections. This technique was successfully performed in 2 consecutive cases of large olfactory groove meningiomas. RESULTS In all anatomic dissections, satisfactory exposure of the cranial base was achieved while keeping the middle turbinate, uncinate process, ethmoid bulla, and middle meatus intact bilaterally. Successful resection of 2 consecutive cases of olfactory groove meningioma was performed using this approach. CONCLUSIONS The endoscopic superior ethmoidal approach for anterior cranial base resection is a feasible and safe approach that maximizes preservation of the nasal structures while providing optimal access to the anterior skull base. It can be used in pathologies that involve the anterior cranial base and do not involve the nasal structures.
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Affiliation(s)
- Maria Peris Celda
- Department of Neurosurgery, Albany Medical Center, Albany, New York, USA
| | - Tyler Kenning
- Department of Neurosurgery, Albany Medical Center, Albany, New York, USA
| | - Carlos D Pinheiro-Neto
- Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, Albany Medical Center, Albany, New York, USA.
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